John H. Rex, MD, FACP
Vice President, Clinical Infection
AstraZeneca Pharmaceuticals

Tell me a bit about your background and how you got started in the health care field.

I received my medical degree from Baylor College of Medicine (1982), trained in Internal Medicine at Stanford University Hospital (1984-1987), and trained in Infectious Diseases at the National Institute of Allergy and Infectious Diseases (1987-1992). I served on the faculty of the University of Texas Medical School at Houston from 1992-2002, during which time my work focused on laboratory studies of novel antifungal agents, clinical trials of novel antifungal agents, and hospital epidemiology. In 2003, I moved to AstraZeneca Pharmaceuticals where I currently serve as Vice President, Clinical Infection. In this role, I lead AstraZeneca's efforts to develop a portfolio of novel antibacterial, antimycobacterial, and antiviral agents.

How did you come to your current position at AstraZeneca?

After 15 years in medical mycology (five years at the National Institutes of Health [NIH] and 10 years at the University of Texas Medical School), my awareness of the rapidly expanding burden of antimicrobial resistance combined with AstraZeneca's intent to invest in discovery of novel agents to cause me to make a move. My sense of acute need was substantially driven by having served for five years as the hospital epidemiologist at Hermann Hospital in Houston, a large tertiary care facility with many ICU beds.

Tell me about your involvement in professional societies outside CLSI?

I sit on the US Food and Drug Administration (FDA) Anti-Infective Drug Advisory Committee as the Industry Representative. I am also an Editor for Antimicrobial Agents and Chemotherapy. In addition, I am a Highlights Advisor for Nature Reviews Microbiology, serve on several editorial boards, and am an Emeritus Editor for www.doctorfungus.org a nonprofit website devoted to dissemination of information about medical mycology.

How did you become involved with standardization?

I began working with CLSI in approximately 1991. I needed a way to test the Candida isolates that I was collecting from the first major trial of fluconazole vs amphotericin B. This led me to learn about the CLSI antifungal susceptibility testing committee. I wrote a review article¹ with help of the Chairholder of the committee, John Galgiani. After publication, I was asked to join the committee. Currently, I serve as Chairholder of the CLSI Subcommittee on Antifungal Susceptibility Tests, as well as Vice Chairholder of the Area Committee on Microbiology.

How have you benefited by becoming a CLSI volunteer?

A motherhood and apple pie question! It's been about having colleagues with whom to create validated tools. You can’t create these alone and we do really need them.

In April 2008, CLSI released an updated Reference Method for Broth Dilution Antifungal Susceptibility Testing of Yeasts; Approved Standard—Third Edition (M27-A3) and complementary document, Reference Method for Broth Dilution Antifungal Susceptibility Testing of Yeasts; Third Informational Supplement. CLSI also published Reference Method for Broth Dilution Antifungal Susceptibility Testing of Filamentous Fungi; Approved Standard—Second Edition (M38-A2) in April 2008. In what ways will microbiologists and manufacturers benefit from using these updated standards?

The updates provide quality control (QC) data on newer drugs and provide a variety of small technical improvements.

Why is it important that microbiologists and manufacturers stay updated on these standards?

Microbiology doesn’t stand still! Our understanding of the best ways to do susceptibility testing is still surprisingly limited, and improved methods are continuously appearing.

Do you have any other recommendations for what you would like to see occur within CLSI, either in the area of microbiology or within the organization in general?

CLSI needs to continue to maintain its broad focus on delivering high quality tools to the community. It has been and should continue to be a fantastic resource.

References

1Rex JH, Pfaller MA, Rinaldi MG, Polak A, Galgiani JN. Antifungal susceptibility testing. Clin Microbiol Rev. 1993;5:367-381.

"Volunteer Focus” is an eNews feature that focuses on Clinical and Laboratory Standards Institute (CLSI) volunteers from different areas of the health care community, and the contributions they make to the patient-testing world through CLSI and their daily work. To recommend a volunteer to be featured in an upcoming issue, e-mail customerservice@clsi.org. [ return to top ]